Two of the newest pediatric subspecialists at KU Wichita Pediatrics - hematologist-oncologists Dr. Nathan Hall and Dr. Rajoo Thapa - came from near and far to expand the care and resources available to young Kansans suffering from cancer and diseases of the blood.

Hall grew up in Buhler, Kansas, and Thapa in India before receiving their training, respectively, in pediatric hematology-oncology at Children's Mercy Hospital in Kansas City and St. Jude's Children's Research Hospital in Memphis. Both were drawn to Wichita by the possibilities of setting up a new practice, the energy and the focus of a facility - Wesley Children's Hospital - dedicated just to kids, and the chance to help establish a Children's Oncology Group program there.  

Each saw the need for increasing the number of physicians fighting children's cancer in Wichita, where one doctor - David Rosen - has long fought that battle alone, serving kids not only in the Wichita area but the entire western half of the state.   

"During my first year of fellowship, I saw patients have to drive seven hours for treatment. I know what it was like to travel for specialty care. You're taking families out of communities," said Hall, adding that he sought out Wichita. "I called up Dr. Pate and said, 'I want to be your pediatric hematology-oncology guy down there.' I am thrilled to serve the greater state of Kansas. There are a lot of kids we can help keep at home."   

"I like challenges, and pediatric oncology is the ultimate challenge. We not only treat the child but we treat the family. Cancer has a great impact on the family," said Thapa, noting that the stress of contending with the disease can bring separation and divorce. "When you help these kids, it's a different level of satisfaction."   

"It gives us a broader bandwidth so more kids can be treated in the community across hematology and oncology," Dr. Brian Pate, chair of pediatrics at the KU School of Medicine-Wichita, said of the doctors' arrival. "By increasing our resources, we can do things like COG and that could bring new treatment options and the national networking."  

The doctors

Pancreatic cancer claimed the life of Hall's grandmother when he was growing up, and spurred his desire to "explore why cancer does what it does."  

"From middle school to high school, I always wanted to do adult oncology. During rotations, I found I enjoyed working with kids much more than adults," said Hall, a Kansas State University graduate who earned his medical degree and master's in biomedical sciences from Kansas City University of Medicine and Biosciences and an MBA from Rockhurst University. Hall is the father of a 4-year-old, 2-year-old and twins under a year old and said "my family is my hobby."  

"Every decision I make, I try to put myself in their shoes," he said of his young patients and their families. "It doesn't make it any easier, but they need a stable person to guide them, to help ease their minds that we are on this journey together," said Hall.  

Admitting that his job is tough, Hall says, "Every night I come home and hug my kids."   

Thapa earned his medical degree at Calcutta Medical College in Kolkata, West Bengal, India, in 2002 and was a pediatrics resident at the Institute of Child Health in Kolkata and then at Upstate Golisano Children's Hospital in Syracuse, N.Y., before going to St. Jude's.  

"Research is important, but clinical care is even more important," Thapa said. "You build rapport with families over many years. There are families I am still in contact with. It's a great feeling and privilege to share these moments with the family. They trust and have faith that you can help."  

"The hope is - we'll get there someday - to cure 100 percent of the kids," said Thapa. "It was one of the things that motivated me to go this way."  

The COG: Children's Oncology Group

By becoming a Children's Oncology Group member institution, Wesley and its doctors will not only be utilizing the latest in cancer research, but contributing to it as well.   

The COG, supported by the National Cancer Institute, is the world's largest organization conducting clinical trials for childhood cancer victims. It's made up of more than 9,000 cancer experts at over 200 institutions in North America and elsewhere around the globe. Since all childhood cancers are rare, most children with a disease are under study in some way or at some point during treatment.    

"It means you're a part of a nation and worldwide research organization that will drive the next phase of treatments," Hall said. "Joining the COG means that Wichita is helping drive up cure rates worldwide."  

Tiffany Stepien, physician practice coordinator with Wesley's pediatric intensive care unit, is working to track and pull together the many pieces needed for the hospital's application to join COG. The hospital, once its application is approved, would be the first COG institution in Kansas, one of a handful of states without one.  

"We want to grow pediatric oncology and the success rate and care we can offer at Wesley and to the whole state," Stepien said.  

Along with having physicians in place to provide the care - Hall is research and medical director of the COG team - many other services are required: a referral network of specialists; pediatric-certified nurses, nutritionists, child life specialists, pharmacists, psychologists and other staff; follow-up care for survivors; access to support groups; and education for patients and families, among others.  

The current timeline is to submit the application next August and then undergo an initial site visit by a COG team. The visit will be followed by 18 months of data collection, then another site visit to complete the process.  

KU School of Medicine-Wichita students and residents will benefit from the program, Stepien said. "They will be able to learn and shadow, because patients will be seen at Wesley."   

Hematology gets a boost

The hematology side of the specialty is another area bolstered by the two new specialists. Previously, patients with such blood diseases as sickle cell anemia, hemophilia and other platelet or cell abnormalities had to venture elsewhere for care.  

"Some of our hematology patients struggle with a cure. With sickle cell, there is still not a cure. Severe hemophilia, they have all kinds of complications. It's a lifelong illness. They need an equal level of care as our oncology patients," Thapa said. "For the most part, hematology care can now be taken care of locally," he said.  

Thapa and Hall are practicing in the Medical Arts Tower, which adjoins Wesley and its new Children's Hospital. "Our goal is to become a major referral center for hematology and oncology. The exciting part about starting a group is that you get to put your own footprint upon it," Hall said of setting up a new practice.  

"With the Children's Hospital, I saw a great opportunity," Thapa said. "If we have the presence of all subspecialties, we can treat all the kids from here or other parts of the state. The kids' best interests are always at the forefront. "  

Pate, who helped bring both doctors here, said the services they can provide are all about the continuum of care.  

"We have to take the amazing gift that Dr. Rosen provides in the community over three decades of service and have a sustainable plan so that three decades from now we are still meeting those needs," Pate said. "And with this growth, I think we are securing that future resource."